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New SBRT radiation treatment tracks tumors as they move

by Nancy Ryerson, Staff Writer | December 19, 2012
The Vero technology at the University of Florida.
The University of Florida Proton Therapy Institute in Jacksonville recently installed a new device that tracks tumor movement in real time. Radiation oncologists hope the technology, called Vero, will help fight against metastatic cancer, in which the disease has begun to spread from its original site to other parts of the body.

The equipment delivers stereotactic body radiotherapy (SBRT) that allows oncologists to follow the tumors as they move with the patient's breath or heartbeat. The equipment, a cooperative partnership between Brainlab AG and Mitsubishi Heavy Industries Ltd., is only the second installed in the United States.

"The other one is in Texas, where it's being used to treat prostates," said Dr. Paul Okunieff, a professor and chair of the UF department of radiation oncology and director of the UF Shands Cancer Center. "We're the only ones really trying to use the Vero to treat really difficult patients, that is, patients with metastatic disease, as a steady diet."

Usually, metastatic cancer is treated with chemotherapy alone, along with a short course of medium-dose radiation to reduce symptoms of a tumor. That kind of treatment is not meant to permanently ablate the tumor, Okunieff said.

"As an example, if a person has two tumors and one of them in the lung is going to be dangerous, that's when you would leave the other one out, and that one would get chemo," said Okunieff. "What we've been saying is this person has three spots. Let's try and ablate all three of them, and see what happens."

Okunieff said Vero's tracking technology will allow for extremely tight margins so almost no normal tissue will receive a high does of radiation.

The Vero technology is part of the University of Florida's Metastatic Cancer Program, which began accepting patients for treatment in October. The program enrolls patients in clinical research studies in order to generate more scientific evidence on the benefits of treating metastatic cancer in its early stages using SBRT. Okunieff, along with colleagues from the University of Rochester, published research indicating that the chances for long-term survival improve significantly when patients with five or fewer lesions in metastatic disease are treated with high dose, targeted SBRT. The research suggested the treatment can lead to long-term overall survival rates of as much as 46 percent for certain types of metastatic cancer.

"We're really excited about the preliminary data," said Okunieff. "That's why we bought the updated technology, to make it even better."

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